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Form Atd25 - Commercial / Agricultural/ Industrial Personal Property-Owned Declaration Schedule For 2012

Form ATD25

State of Wyoming,

Page 1 of 2

COMMERCIAL / AGRICULTURAL/ INDUSTRIAL

PERSONAL PROPERTY—OWNED

DECLARATION SCHEDULE FOR 2012

County Number

Parcel #

Act Number

Personal Prop. Type

DO NOT USE - FOR ASSESSORS USE ONLY

Date received:

By:

Name and address of personal property listed here: (please make any corrections here)

Please indicate location of personal property: (please make any changes here)

PERSONAL PROPERTY DETAIL LISTING: Please list all personal property you own and use in your business or operation (Include all

NAICS CODE:

installed costs)—do not list licensed vehicles (please indicate any changes to the following list by lining out the items that have been removed

and filling in the new items purchased) (duplicate form as necessary). Please sign the reporting rendition on the bottom of page 2 and return the

_______________

completed form by March 1.

Item

Make

Model

Serial #

Year

New/Used

Original

Please see second page for leased equipment reporting requirements.

Form Atd25 - Commercial / Agricultural/ Industrial Personal Property-Owned Declaration Schedule For 2012